A 43-year-old man is admitted to the emergency department with a fracture of the base of his skull. A thorough physical examination reveals that a number of structures have been injured, possibly including the right greater petrosal nerve. Which of the following conditions needs to be identified during physical examination to confirm the diagnosis of greater petrosal nerve injury?

Correct Answer: Dryness of the right cornea due to lack of lacrimal secretion
Description: The greater petrosal nerve carries parasympathetic fibers that are involved in the innervation of the lacrimal gland, as well as the mucosal glands of the nose, palate, and pharynx. As a result, an injury to the right greater petrosal nerve would be expected to result in decreased lacrimal secretions for the right eye. The sublingual and submandibular glands receive their parasympathetic fibers from the facial nerve via the chorda tympani and the lingual nerve. They would be unaffected by this lesion. The parotid gland receives its parasympathetic secretory innervation from the glossopharyngeal nerve via the lesser petrosal and auriculotemporal nerves and would be unaffected. Taste to the anterior tongue is provided by the facial nerve via the chorda tympani, and general sensation to the anterior tongue is provided by the mandibular division of the trigeminal nerve via the lingual nerve.
Category: Anatomy
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